| NPI | 1477901320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: FL 1706AD069401) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 1706AD069401) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |